Temporary and permanent crowns are anchored to a patient's maxilla or jaw by way of dental implant. The current method of placing a dental implant is time consuming, complex, and expensive. More specifically, current implant installation begins with planning from the implant location up to the desired crown location. That is, the dentist or oral surgeon first installs the implant at the tooth extraction site; ideally where ideal bone mass is present. After the implant is installed, an abutment, which connects the crown to the implant, and the crown are added to the implant. Often, the abutment and/or crown may have to be modified to be interconnected to the implant, because the best implant location with respect to the desired crown location is not feasible due to bone availability, implant angulation, and/or issues associated with alignment with, or placement next to, adjacent teeth.
The first step in identifying the ideal implant location is accomplished by assessing bone quantity, density, etc., which is done by obtaining radiographic measurements of the patient's mouth. To ensure the radiographic images correctly characterize the patient's physiology, a radiographic guide must be made. A common process of radiographic guide fabrication is generally comprised of first forming a cast of the patient's dental arch that includes at least one void (e.g., area associated with the extracted tooth or teeth) that is to be filled with a dental implant and permanent crown. A denture tooth is adjusted to fit the space and wax, or other adhering substance, is subsequently used to secure the denture tooth within the void of the dental cast. Alternatively, a custom made diagnostic tooth fills the void of the cast.
One such method involves using putty to make an impression of the denture tooth or custom made diagnostic tooth and the surrounding portions of the dental arch cast. The putty is then removed to reveal an impression of the denture tooth or custom made diagnostic tooth. The putty is trimmed to remove the impressions of the surrounding teeth. The denture tooth or custom made diagnostic tooth is then removed from the cast. A separating agent is then applied to the dental cast, and the putty impression of the denture tooth or custom made diagnostic tooth is filled with orthodontic resin (acrylic) to form a replica of the original denture tooth or custom made diagnostic tooth. The putty impression with the orthodontic resin is placed over the void and allowed to cure. The cured acrylic tooth that represents the lost tooth is removed from the putty impression and the dental arch cast and trimmed to remove excess resin.
Next, undercuts in the dental arch cast are filled with wax and the trimmed acrylic tooth that represents the lost tooth is placed back into the previously-formed putty impression. In addition, an orthodontic acrylic resin is mixed and a monomer is added to the fabricated acrylic tooth. The acrylic tooth, which is still in the putty, is placed back on the dental arch cast at the void site. The previously mixed orthodontic acrylic resin, which is still yet to be fully cured, is placed over the dental arch cast. The partially-cured orthodontic acrylic resin is molded over the “roof” (assuming a tooth associated with the patient's maxilla requires replacement) of the dental cast and the cast teeth adjacent to the putty-encapsulated acrylic tooth, thereby bonding the acrylic tooth to the orthodontic acrylic resin. Excess resin is trimmed and removed from the portion of the “roof” and from portions of the dental arch cast outer surface. The combination of orthodontic acrylic resin, putty, acrylic tooth, and dental arch cast is secured and the orthodontic acrylic resin is allowed to cure.
After the orthodontic acrylic resin is cured, the putty is removed and the acrylic tooth remains associated with the cured resin. The radiographic guide comprises the cured orthodontic acrylic resin removed from the dental arch cast. That is, the radiographic guide comprises an impression of the existing teeth with an interconnected acrylic tooth. Gutta percha markers or other radio-opaque markers, which are familiar to those of ordinary skill in the art, are then added to the radiographic guide. The radiographic guide is placed in the patient's mouth wherein the representation of the denture tooth or custom made diagnostic tooth is placed in the void associated with the lost tooth, and various radiographic images of the patient's mouth are obtained.
A surgical guide, which may be a copy of the radiographic guide, is then fabricated. Information gleaned from the radiographic images helps to define holes in the surgical guide that help the oral surgeon locate and drill a dental implant into the patient's mouth. Again, as one of ordinary skill the art will appreciate, this process is time consuming and complex.
Thus it is a long felt need in the field of dentistry and oral surgery to provide a more efficient and cost-effective way to create a radiographic and surgical guide. The following disclosure describes an improved method of fabricating a radiographic guide that can also be used as a surgical guide. The contemplated radiographic guide includes a provisional implant crown, or an impression of a provisional implant crown closely matched to a provisional implant crown that will be interconnected to an implant abutment after the implant surgery is completed.